Healthcare Provider Details

I. General information

NPI: 1023843729
Provider Name (Legal Business Name): CATHERINE MCAULEY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 ELLIOTT DR SUITE 102: JOHN CARUSO TRINITY HEALTH
YPSILANTI MI
48197-8634
US

IV. Provider business mailing address

20555 VICTOR PKWY FL 3
LIVONIA MI
48152-7031
US

V. Phone/Fax

Practice location:
  • Phone: 734-727-3032
  • Fax:
Mailing address:
  • Phone: 734-727-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PAUL GUSHO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 248-763-3575